How relationships can change

Examples of changes

• I might need to take on new responsibilities that will reverse our roles.
• If I’m doing all the caring, they may feel like they’ve lost their independence.
• My concern might come across as being overprotective or controlling.
• I may feel like it would be selfish to talk about my needs when they are having to go through cancer treatment.
• I may avoid sharing how I’m feeling because I’m scared of overwhelming the other person when they have enough to worry about.
• The intimacy we shared might be replaced by the caring role.
• We might need to re-evaluate our priorities and set new goals or put them on hold.

Ways to manage changes

• Talk about the changes to avoid misunderstandings. Discuss ways to meet each other’s needs.
• Allow time to get used to the changes, particularly if roles have reversed.
• Set boundaries to maintain independence and allow both of you to feel in control.
• Arrange home help if you or the person you are caring for feel uncomfortable doing the bathing and dressing.
• Give the person you’re caring for the chance to do things for themselves.
• Use touch to show you care.
• If you and the person you’re caring for find it difficult to discuss your different needs without both becoming defensive, consider seeing a counsellor or psychologist. They can suggest ways to approach such conversations.

Lesbian, gay, bisexual, transgender, queer or questioning, and intersex (LGBTQI) people may face specific challenges as carers. They may worry about health professionals or the person’s family or friends accepting them, or wonder if support services are LGBTQI-friendly. Visit the Carer Gateway for more information.

You can also contact the national counselling and referral service for LGBTQI people at Qlife, or the National LGBTI Health Alliance.

If you are caring for a partner, you may find the cancer and its treatment affects your sexual relationship. This will depend on the type of cancer, the treatment and its side effects.

• Tiredness can make people lose interest in sex during and after treatment. This is called a lowered libido.
• Cancer treatments, medicines and pain can also reduce libido and may affect someone’s physical ability to have sex.
• A person’s body image may change during and after treatment, making them feel self-conscious and embarrassed.
• The emotional strain of cancer or caring may preoccupy you and cause you to lose interest in sex.
• Many people worry that physical intimacy might be painful.
• You might find it hard to switch from being carer and patient back to being sexual partners.
• You might feel guilty if your partner is unable or unwilling to be sexually active and you still want a sexual relationship

How to manage sexual changes

• Talk about how you’re feeling – communication is an important sexual tool.
• Spend time together to maintain intimacy in your relationship. If your partner is well enough, you may be able to go to the cinema or out to dinner. otherwise, watch a movie at home, give each other massages, do a crossword together, look through old photo albums or chat about how you first met.
• Tell your partner you care. Your partner may need reassurance that you love them and find them attractive despite the changes from their illness or treatment.
• Have your partner show you any body changes before sexual activity. This may allow both of you to get used to how the differences make you feel.
• Discuss any concerns you have about being intimate with your partner. If you keep quiet and withdraw, your partner may misinterpret your actions  and think they’re no longer desirable. Being open with your partner about your sexual needs can help you identify ways to manage them.
• Keep an open mind about ways to give and receive sexual pleasure, especially if your usual ways of lovemaking are now uncomfortable or not possible. Some people find lubricants or sexual aids help. For a while, you may need to focus on kissing and cuddling.
• Take things slowly and spend time getting used to being naked together again.
• Be patient. You may find that any awkwardness will improve with time and practice.
• Talk to a counsellor who specialises in helping couples with intimacy and sexual issues. The occupational therapist on your treatment team can suggest practical strategies for positioning and fatigue management.

Download our ‘Sexuality, Intimacy and Cancer’ booklet

Listen to our ‘Sex and Cancer’ podcast episode